<div id="content_header">
  <h3>Make Up Test Fee</h3>
</div>

<div class="row">
  <div class="col-md-6 col-lg-4">
    <form name="form" role="form" ng-submit="submit()">

      <h4>Final</h4>
      <div class="form-group" ng-class="{ 'has-error': errors.Amount}">
        <label class="required" for="Amount">Amount</label>
        <span class="error" ng-show="form.Amount.$error.required">Required!</span>
        <input type="text" name="Amount" class="form-control" id="Amount" placeholder="Input field" ng-model="fee[0].Amount" required>
        <error-widget field="errors.Amount"></error-widget>
      </div>

      <div class="form-group">
        <label for="currency">Currency</label>
        <select name="currency" id="currency" class="form-control" ng-options="currency as currency.Name for currency in currencies" ng-model="fee[0].Currency">
          <option value="" ng-hide="fee[0].Currency > 0">Please Select a Currency</option>
        </select>
      </div>

      <h4>Speaking</h4>
      <div class="form-group" ng-class="{ 'has-error': errors.Amount}">
        <label class="required" for="Amount">Amount</label>
        <span class="error" ng-show="form.Amount.$error.required">Required!</span>
        <input type="text" name="Amount" class="form-control" id="Amount" placeholder="Input field" ng-model="fee[1].Amount" required>
        <error-widget field="errors.Amount"></error-widget>
      </div>

      <div class="form-group">
        <label for="currency">Currency</label>
        <select name="currency" id="currency" class="form-control" ng-options="currency as currency.Name for currency in currencies" ng-model="fee[1].Currency">
          <option value="" ng-hide="fee[1].Currency > 0">Please Select a Currency</option>
        </select>
      </div>

      <button type="submit" class="btn btn-primary" >Submit</button>
    </form>
    
  </div>
</div>